腹主动脉旁淋巴结切除在Ⅰb_2/Ⅱa_2期宫颈癌手术中的价值  

Value of abdominal para-aortic lymph node dissection in the radical surgery for cervical cancer in stage Ⅰb_2/Ⅱa_2

作　　者：张丽[1] 曲坚[1] 徐静[1] 

机构地区：[1]济宁医学院附属医院妇科,山东济宁2721000

出　　处：《癌症进展》2016年第9期854-856,860,共4页Oncology Progress

基　　金：济宁市科技发展计划项目(2012jnfs02)

摘　　要：目的探讨腹主动脉旁淋巴结切除在Ⅰb2/Ⅱa2期宫颈癌根治性手术中的临床价值。方法选取宫颈癌根治性手术治疗的60例患者进行回顾性分析,根据治疗方法的不同将患者分为A、B两组,每组各30例。A组患者采取宫颈癌根治性手术联合腹主动脉旁淋巴结切除进行治疗,B组患者采取宫颈癌根治性手术进行治疗。比较两组患者的手术时间、术中出血量、术后并发症及远期生存指标。结果 A、B两组患者的手术时间、术中出血量比较,差异无统计学意义(P﹥0.05);A、B两组患者腹部切口液化/裂开、输尿管损伤、淋巴囊肿、尿潴留、阴道瘘、肠梗阻、肺部感染的发生率比较,差异均无统计学意义(P﹥0.05);A组患者的3年、4年无瘤生存率分别为80.00%、60.00%,高于B组患者的53.33%、33.33%,差异均具有统计学意义(χ2=4.800,P=0.028;χ2=4.286,P=0.038);A、B两组患者的3年、4年总生存率比较,差异均无统计学意义(P﹥0.05);A组患者的生存时间为45.0个月,长于B组患者的41.0个月,差异有统计学意义(Log-rank mantel cox=4.245,P=0.039)。结论Ⅰb2/Ⅱa2期宫颈癌根治性手术中同时行腹主动脉旁淋巴结切除有利于患者的远期预后。Objective To investigate the clinical value of abdominal para-aortic lymph node dissection in the radical surgery for cervical carcinoma in stage Ⅰb2/Ⅱa2. Method 60 cases that were administered with radical hysterectomy were retrospectively analyzed, and were stratified as group A and B, with 30 cases in each, given radical surgery＋abdominal para- aortic lymph node dissection, or radical surgery alone, respectively. The operative time, intra- operative blood loss, postoperative complications and long-term survival of the two groups were compared. Result There was no significant difference in regard of operative time and blood loss between the two groups（P〉0.05）; And the incidences of liquefaction/split of abdominal incision, ureteral injury, lymphatic cyst, urinary retention, vaginal fistula, intestinal obstruction, pulmonary infection were also similar between the two groups（P〉0.05）; The 3-year and 4-year disease-free survival rate were 80.00% and 60.00% in group A, higher than those in group B at 53.33% and 33.33%, respectively（χ^2=4.800, P=0.028; χ^2=4.286, P=0.038）; While the 3- year and 4- year overall survival rate were comparable in the two groups（P〉0.05）; But the survival time of patients in group A was 45 months, significantly longer than that of group B at41 months（Log-rank mantel cox=4.245, P=0.039）. Conclusion Patients undergoing radical surgery for cervical cancer in stage Ⅰb2/Ⅱa2may benefit from abdominal para-aortic lymph node dissection in respect of long-term prognosis.

关 键 词：腹主动脉旁淋巴结 宫颈癌 根治性手术 

分 类 号：R737.33[医药卫生—肿瘤]